Up to 50% of people develop hemorrhoids by age 50¹ - and the impact goes beyond discomfort. Hemorrhoids and anal fissures affect how you sit, sleep, work, and move through your day. For chronic sufferers, the constant cycle of flare-ups takes a toll on quality of life, and embarrassment means most people suffer in silence longer than they should.²

When our 42-year-old TCD tester (we'll call her Sarah) developed recurring hemorrhoids aggravated by her desk job, she looked online to find a treatment more effective than the standard treatments recommended by her doctor. But what actually works, and why?

We tested and reviewed online treatment Bummed Rapid Relief Hemorrhoid & Fissure Rx Cream against standard treatments Preparation H Hemorrhoidal Cream and Anusol-HC Cream. And Dr. Robert Woodward (MD), a primary care physician who treats patients with hemorrhoids and anal fissures, lends his expert medical opinion. We found one clear winner - read on to find out which.

What to Look For in a Hemorrhoid Treatment

Hemorrhoids are lumps that occur when veins in the lower rectum become swollen and inflamed - typically from pressure due to straining, prolonged sitting, or chronic constipation. That same pressure often causes anal fissures - small tears in the anal lining from over-stretching - which exposes the underlying muscle, leading to spasm of the internal anal sphincter. That spasm puts constant pressure on the affected area, cutting off blood flow and preventing tissue from healing. That's why the best treatments both relieve pain fast and address the underlying muscle tension to heal fissures and hemorrhoids.

Over-the-counter (OTC) creams work by temporarily shrinking swollen blood vessels. "They can offer short-term comfort," says Dr. Woodward, "but they increase sphincter tightening, which cuts off the blood flow needed for healing - the opposite effect of actually treating fissures and hemorrhoids.”

To actually heal, a treatment needs to relax the anal sphincter and improve blood flow to the damaged tissue. The most effective formulations use nitroglycerin - a nitric oxide donor that relaxes the internal anal sphincter and restores blood flow - to force the muscle to release tension and let blood flow reach the area for repair.³

In short: look for a treatment that provides immediate relief, heals at the source, and works for both hemorrhoids and fissures. How do Bummed, Preparation H, and Anusol-HC compare? Let's find out.

Hemorrhoid & Fissure Treatments Compared

Formulation & Ingredients: Bummed Wins

"An effective hemorrhoid treatment needs to work on multiple levels at once - numbing the pain, calming the inflammation, relaxing the sphincter, and protecting against infection," says Dr. Woodward. "A cream that only does one or two of those things will only partially relieve symptoms."

Most people start with OTC options and find they don't work - and eventually end up visiting a doctor to get the active ingredients already present in Bummed. We recommend skipping that process and starting with Bummed for true healing. Here's why:

🥇 Bummed Rapid Relief Hemorrhoid & Fissure Rx Cream wins with the most comprehensive formulation we tested. It's the only treatment with active ingredients that target both the pain and the root cause:

• Lidocaine & Bupivacaine: Dual anesthetics for immediate relief that lasts for hours. Lidocaine kicks in within 30-60 seconds; Bupivacaine extends comfort for hours after.
• Nitroglycerin: A nitric oxide donor that relaxes the internal anal sphincter, restores blood flow to the tissue, and actively promotes healing - for both hemorrhoids and fissures.
• Hydrocortisone: Reduces inflammation, swelling, and irritation at the site.
• Metronidazole & Aloe: Antimicrobial protection against infection, plus gentle soothing for sensitive tissue.

In a randomized controlled trial of 80 patients, topical nitroglycerin was 109% more effective at healing anal fissures than placebo.⁴ That makes Bummed the only treatment in our test clinically proven to heal hemorrhoids and fissures.

❌ Preparation H Hemorrhoidal Cream offers only short-term relief, designed to mask symptoms rather than treat the cause:

• Phenylephrine HCl: A vasoconstrictor that temporarily shrinks swollen tissue but does nothing to relax the sphincter - and may actually reduce blood flow further in fissure patients.
• Petrolatum: A basic skin barrier with no healing or anti-inflammatory effect.

❌ Anusol-HC Cream is a single-ingredient prescription - 2.5% hydrocortisone - that reduces inflammation and itching, with no healing properties. It has no effect on sphincter tone, provides no numbing, and does nothing to restore blood flow. And prolonged use thins the tissue over time, which can make fissures worse - that’s why clinical guidelines limit use to 1-2 weeks.⁵

Effectiveness: Bummed Wins

Sarah tested each product for approximately two weeks before moving to the next:

❌ Preparation H Hemorrhoidal Cream offered the least relief of the three. Sarah tested it first and found it dulled the burning for about 45 minutes before the discomfort returned, leaving her reapplying multiple times a day just to get through work. After two weeks of daily use, her underlying symptoms hadn't changed. "I only felt relief right after putting it on," she said. “I got tired of having to run to the bathroom to reapply.” 

🥈 Anusol-HC Cream was second with meaningful reduction in itching and inflammation within the first few days - but only temporarily. Given the tissue-thinning risk of extended hydrocortisone use, Sarah stopped after one week as directed, and her symptoms returned within days. "As soon as I stopped, it came right back. It felt like a Band-Aid rather than a fix." 

🥇 Bummed Rapid Relief Hemorrhoid & Fissure Rx Cream was the only treatment that actually improved Sarah's symptoms over time. Within a minute of applying it, she felt numbing relief - and that lasted around 4 hours per application, making long stretches at her desk manageable. By the end of week one, flare-ups were less frequent. By week two, tissue irritation had improved significantly. "It's the first thing I've tried that feels like it's actually working on the problem," she said. 

Convenience: Bummed & Preparation H Tie

🥇 Bummed Rapid Relief Hemorrhoid & Fissure Rx Cream makes getting a prescription treatment easy - the online intake takes under two minutes, a board-certified clinician reviews your submission, and the medication ships directly to your door in discreet packaging. For Sarah, the whole process from intake to delivery took four days, with no in-person appointment, waiting room, or pharmacy line.

🥇 Preparation H Hemorrhoidal Cream is available over the counter at any pharmacy or online retailer - without a prescription. 

❌ Anusol-HC Cream required Sarah to schedule a PCP appointment, get an in-person examination, and pick up a physical prescription at a pharmacy. The whole process took about a month between the appointment waitlist and waiting for her pharmacy to fill the prescription.

Price & Value: Bummed Wins

How does the cost of a 3-month supply compare?

🥇 Bummed Rapid Relief Hemorrhoid & Fissure Rx Cream costs $96.90 for your first order with TCD's discount ($114 without). This includes a $49 virtual specialist consultation - which covers 12 months of refills - and $47.90 for the first 3-month supply; any future refills cost just $65. While the upfront price is higher, it's a clinical-grade treatment designed to heal the injury completely.

🥈 Preparation H Hemorrhoidal Cream costs around $15 per tube, or roughly $60 over 3 months assuming multiple daily reapplications. Because it doesn't heal the underlying cause, many users eventually end up at a doctor's office anyway - adding cost and time to the process.

❌ Anusol-HC Cream costs approximately $40 for a 28-day prescription, or around $120 for a 3-month supply - plus a copay for the physician visit. And with use limited to 1-2 weeks at a time due to tissue-thinning risks, most patients end up cycling through tubes without ever resolving the underlying issue.

The Overall Winner: Bummed Rapid Relief

Which hemorrhoid and anal fissure treatment is most effective? After comparing Bummed, Preparation H, and Anusol-HC on ingredients, relief, long-term healing, and convenience, we recommend the only option that treats both hemorrhoids and fissures at the source. And that's Bummed.

Dr. Woodward agrees: "I recommend Bummed for anyone dealing with recurring hemorrhoids or fissures. The combination of local anesthetics, a steroid to keep down swelling, aloe to soothe the skin, an antibiotic to fight any potential infections, and nitroglycerin to increase the blood flow to the area, which is the most important factor in healing, is unique and hard to beat.”

Ready to try Bummed? Use code TCD for 15% off your first order:

Note: A small percentage of users experience mild headaches from topical nitroglycerin - Bummed also offers a Long-Acting formulation with diltiazem for patients who are sensitive to GTN.

Prescription products require an online medical consultation to determine eligibility. Compounded medications are not subject to FDA approval.

The content of this article is for informational purposes only and should not replace professional medical advice. If you are experiencing rectal bleeding or severe symptoms, consult a healthcare provider.

References

1. American Society of Colon and Rectal Surgeons
2. Frontiers in Neurology
3. Lancet
4. Gut Journal
5. Drugs.com